This World Continence Week, TUF is embarking on a campaign to end the silence of incontinence. There are staggering facts and figures to prove that this topic should no longer be ignored in regular conversations about health.
There are physical, emotional and financial factors to consider in the topic of urinary incontinence and how it is approached.
A leading urology surgeon has warned that incontinence costs the NHS billions of pounds each year as sufferers seek treatment to fix the condition.
With an ageing population and rising levels of obesity, the £1.8 billion cost for incontinence each year is set to rise, putting surgeons and experts under increasing pressure.
Tamsin Greenwell, urological surgeon at University College Hospital in London, says that some patients are running themselves into debt to finance incontinence pads. Private costs for incontinence pads are estimated to be 750 million pounds each year.
She said: “Incontinence affects people of any age and often has a huge impact on the lives of the patients I see. It affects their self-worth, their personal relationships, intimacy, their finances and it has a significant impact on their employment. It’s almost impossible to teach or be a policeman or policewoman on the beat if you have to run to the toilet every hour. And it is also hard for many patients to fund containment products like pads while the NHS struggles to deal with this Cinderella condition. The cost of incontinence pads is huge – one patient of mine went virtually bankrupt because she had to buy so many pads since the NHS only pays for a patient to have two to four a day,
“I remember seeing another patient whose whole life had fallen apart – her relationship had crumbled, she couldn’t work and she said if I didn’t operate on her, she didn’t want to live. I think lots of people feel completely isolated and imprisoned. This is desperately sad because it doesn’t have to be this way.”
Ms Greenwell says that although there are an estimated six million people who suffer from incontinence in the UK, it could be double this figure as many more are undiagnosed due to an unwillingness to see their doctor about symptoms.
“It is very important people access help early on – pelvic floor exercises and muscle-training get good results in between 60 and 65 per cent of people urinary incontinence,” said Ms Greenwell.
“But incontinence is not sexy and most people don’t want to admit to having it. It is interesting that people are happy to talk about their sex lives but not about being incontinent, even to their GP.
“This is a travesty because there are a lot of treatments available, such as behavioural training, pelvic floor physiotherapy, and both minor and more major surgical treatments which can be highly effective and get a lot of women and men sorted out. Treatments range from simple to complex and vary depending on the patient’s preferences and what treatments they have had before.”
A survey carried out by national charity The Urology Foundation in April found that 60 per cent of those surveyed admitted they would be embarrassed to speak about urinary incontinence – more so than weight, family, money and relationship troubles. Of the 1,000 respondents, only one per cent associated urinary incontinence with obesity while more than a quarter said they would put off seeking help from their GP.
“A lot of people might not be aware but there is also definitely a link between obesity and incontinence,” says Tamsin. “We assess obesity in terms of body mass index or BMI. A normal BMI is between 20-25. The odds of developing urinary incontinence in a 5-10 year period increase by 30-60% for each 5 unit increase in BMI above normal. Obesity is linked with incontinence because if you are overweight there is more pressure on your bladder and on your pelvic floor and this may lead to overloading of the pelvic muscles that keep you dry. Reducing your weight to this level improves or resolves stress incontinence in 40 per cent of people and improves urge incontinence in about 30 per cent of people. A patient needs to have a BMI less than 35 before we can operate on them because the risk of complications from surgery such as wound infection, chest infection and blood clots are much higher in those with high BMIs.”
Louise de Winter, chief executive of the Urology Foundation, said: “Incontinence costs the NHS nearly £2 billion every year, and the emotional and social costs are equally high. We need to do much more to make people realise that they can take control of their continence issues and that help is at hand. Breaking down taboos plays an important part of this, enabling people to acknowledge there is a problem and seek help to deal with it. Thousands of people are suffering in silence and it simply doesn’t have to be this way.”
